The long-term success of antiretroviral therapy (ART) is increasingly jeopardized by the emergence of HIV-1 drug resistance (HIVDR). Characterizing the res

Drug-resistant tuberculosis (DR-TB) poses a critical public health challenge in Jiangxi Province, China, where regional resistance patterns remain understudied. This retrospective study analyzed 9,041 suspected TB patients (2022–2023), identifying 3,104 Mycobacterium tuberculosis (M. tuberculosis) cases via PCR-reverse blot hybridization assay (PCR-REBA). Among M. tuberculosis-positive cases, 19.3% exhibited drug resistance, including mono- (9.2%), double- (4.6%), triple- (3.8%), and quadruple-drug resistance (1.7%). Males had higher odds of rifampicin (OR = 1.407, 95% CI: 1.086-1.824, p = 0.01) and isoniazid (OR = 1.959, 95% CI: 1.538-2.495, p < 0.001) resistance. Dominant mutations included rpoB Ser531Leu (32.1%) for rifampicin and katG Ser315Thr (53.6%) for isoniazid resistance. Extrapulmonary TB showed higher susceptibility than pulmonary TB (e.g., rifampicin: 93.47% vs. 87.25%, p = 0.002). These findings highlight the urgent need for rapid molecular diagnostics and targeted interventions in Jiangxi to address distinct DR-TB patterns and demographic disparities.

Monitoring tuberculosis (TB) treatment response remains challenging, necessitating robust host-derived biomarkers. While standard monitoring relies on clinical assessment, adherence, radiological improvement, and microbiological culture conversion, these methods can be slow to manifest.Cytokines like IFN-γ, IL-2, and IL-6 are implicated in the immune response to Mycobacterium tuberculosis (M. tb), but their longitudinal dynamics and discriminative power during treatment are inadequately characterized. These host-derived biomarkers are intended to serve as adjuncts to, rather than replacements for, established clinical and microbiological monitoring protocols. In a retrospective cohort of 163 TB patients, we quantified twelve cytokines using a multiplex immunoassay in paired plasma samples collected pre-treatment and two months post-treatment. Longitudinal changes were assessed via Wilcoxon signed-rank tests, and the discriminatory ability of significant cytokines for treatment status was evaluated using receiver operating characteristic (ROC) analysis. Logistic regression identified factors associated with post-treatment biomarker levels. IFN-γ and IL-6 decreased significantly (median change: -15.4% and − 47.0%, respectively), while IL-2 increased (+ 19.0%). However, their individual power to discriminate pre- from post-treatment status was limited, with area under the curve (AUC) values of 0.555 for IFN-γ, 0.558 for IL-2, and 0.611 for IL-6. Pre-treatment cytokine levels were the strongest predictors of post-treatment concentrations. IFN-γ, IL-2, and IL-6 exhibit significant dynamic changes during early TB treatment, reflecting immunomodulation, but perform poorly as standalone discriminators of treatment status. Future strategies should prioritize multi-parameter models integrating cytokine trends to improve monitoring accuracy. The online version contains supplementary material available at 10.1186/s12866-026-05051-2.

Accurate diagnosis of paucibacillary and extrapulmonary tuberculosis remains a major global challenge, as conventional pathogen-focused methods often lack sensitivity. This study aimed to evaluate whether combining host-derived immune biomarkers could improve diagnostic accuracy. In a retrospective diagnostic accuracy study of 605 participants, nucleic acid amplification tests served as the reference standard. We assessed the performance of adenosine deaminase, interferon-gamma, and interleukin-6 individually and in combination using receiver operating characteristic analysis. Serial (rule-in) and parallel (rule-out) testing algorithms were compared to define strategies for confirmation or exclusion of disease. Here we show that while interferon-gamma was the strongest single discriminator, combinations of biomarkers significantly outperform any single marker. The dual-panel of interferon-gamma and interleukin-6 achieves the highest overall accuracy. Serial testing of adenosine deaminase and interferon-gamma maximizes specificity to 97.4% (95% CI: 95.6-98.7%), providing a reliable rule-in tool. Conversely, parallel testing of all three biomarkers achieves 94.9% (95% CI: 95.6-98.7%)sensitivity, enabling an effective rule-out strategy. The integration of complementary host biomarkers overcomes the inherent limitations of single analyte tests. By enabling adaptable, context-specific algorithms tailored for either high-specificity confirmation or high-sensitivity screening, this approach provides a scalable and cost-effective diagnostic approach, tailored for resource-constrained settings.

Non-tuberculous mycobacteria (NTM) pose diagnostic and therapeutic challenges in tuberculosis (TB)-endemic regions like Jiangxi Province, China, due to cli

Tuberculosis (TB) and non-tuberculous mycobacterial (NTM) detections pose overlapping diagnostic and therapeutic challenges, particularly in high-burden re